重型颅脑损伤术后并发脑积水的影响因素分析

目的分析重型颅脑损伤患者术后并发脑积水的危险因素。方法选择重型颅脑损伤患者319例为研究对象。根据是否发生脑积水分为脑积水组（49例）和无脑积水组（270例）,分析患者术后发生脑积水的相关因素。结果脑积水组与无脑积水组患者的硬膜下及脑内血肿、开放性损伤、是否合并蛛网膜下腔出血、行去骨瓣减压术、硬膜敞开、腰穿脑脊液置换术比较,差异有统计学意义（P〈0.05或P〈0.01）。多因素Logistic回归分析显示,开放性损伤、蛛网膜下腔出血、去骨瓣减压术、硬膜敞开是重型颅脑损伤术后发生脑积水的危险因素（P〈0.01）,而腰穿脑脊液置换术是保护因素（P〈0.01）。结论开放性损伤、蛛网膜下腔出血、去骨瓣减压术、硬膜敞开是重型颅脑损伤患者术后发生脑积水的危险因素,腰穿脑脊液置换术是保护因素。

Analysis on the influencing factors of postoperative hydrocephalus in pa-tients with severe brain injury

Objective To analyze the influencing factors of postoperative hydrocephalus in patients with severe brain injury. Methods 319 cases of patients with severe brain injury were selected as subjects.All patients were divided into hydrocephalus group and non-hydrocephalus group according to whether with occurrence of hydrocephalus,and influencing factors of postoperative hydrocephalus in patients with severe brain injury were analyzed. Results Subdural and intracerebral hematoma,open injury,whether the merger subarachnoid hemorrhage,carried out decompressive craniectomy,subdural open,lumbar puncture and cerebrospinal fluid replacement of hydrocephalus group and non-hydrocephalus group had significant difference（P〈0.05 or P〈0.01）.Logistic analysis showed that,open injury,subarachnoid hemorrhage,decompressive craniectomy,subdural open were risk factors of postoperative hydrocephalus in patients with severe brain injury（P〈0.01）.Lumbar puncture and cerebrospinal fluid replacement was protecting factors（P〈0.01）. Conclusion Open injury,subarachnoid hemorrhage,decompressive craniectomy,subdural open are risk factors of postoperative hydrocephalus in patients with severe brain injury,and lumbar puncture and cerebrospinal fluid replacement is protecting factors.